Skip to Main Content
Skip Nav Destination

Issues

Journal Name Change

Vol. 1-4 (1986-1989) were published under the journal's former title Fetal Therapy.

Fetal Diagnosis and Therapy 2023, Vol. 50, No. 6

Prenatal Diagnosis

Fetal Diagn Ther (2023) 50 (6): 397–405. https://doi.org/10.1159/000533137
Mini Summary

What does this study add to the current knowledge?

  • In this study, we analyzed 2,336 fetal samples and tested multiple platform designs to detect small but potentially significant differences in sensitivity and specificity. We found that the targeted array approach increases the detection of some clinically significant variants, which is crucial for the clinical utility of a platform.

What are the main clinical implications?

  • As array comparative genomic hybridization (aCGH) is offered to all women undergoing invasive testing and has become the norm over traditional cytogenetics, the results of our study are applicable to contemporary populations undergoing invasive testing.

Fetal Diagn Ther (2023) 50 (6): 406–414. https://doi.org/10.1159/000533201
Mini-Summary

  • What does this study add to current knowledge?

    • This multicentre cohort study investigates the performance of screening for preterm preeclampsia (pPE) for the Swiss population according to the Fetal Medicine Foundation (FMF) London algorithm. The different screening parameters for pPE perform well in our population, only pregnancy-associated plasma protein A (PAPP-A) values are higher than expected. The prevalence of pPE in this Swiss cohort is lower than previously described, a fact that we attribute to the screening for pPE and low-dose aspirin prophylaxis in high-risk patients in our cohort.

  • What are the main clinical implications?

    • When using the FMF London algorithm in screening for pPE in the Swiss population, the cut-off should be set rather at 1: ≥75 or lower in order to keep the screen positive rate low at 10–11%. PAPP-A shows a poor performance in screening for pPE and should eventually be excluded for the screening or pPE. Screening of pPE should be recommended to all singleton pregnancies as part of routine first trimester screening.

Fetal Diagn Ther (2023) 50 (6): 415–421. https://doi.org/10.1159/000531781
Summary

  • What does this study add to current knowledge?

    • This study showed that there is an early transplacental antibody transfer after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunization. Moreover, our study gives information about the kinetics of the maternal response to vaccination and the efficiency of IgG transfer across the placenta. Indeed, it seems that for at least 6 months after the last vaccine dose, a valid amount of anti-S1 receptor-binding domain (RBD) IgG is still present such as to protect the mother and to pass into the amniotic fluid.

  • What are the main clinical implications?

    • In addition to transplacental acquired humoral defense, also the transfer of both spike-specific IgG and IgA antibodies into the maternal breastmilk, may be another line of defense for breastfed infants. The main clinical implications are the maternal and fetal protection against viruses. Our findings support the recommendation that immunization is an essential part of care for pregnant women because pregnant women who contract viral infections have greater risk of maternal morbidity and mortality in addition to fetal morbidity.

Fetal Diagn Ther (2023) 50 (6): 422–429. https://doi.org/10.1159/000531780
Mini-Summary

What does this study add to current knowledge?

  • Previously published polynomial reference ranges for fetal atrioventricular (AV) intervals may be useful to exclude a neonatal atrioventricular block (AVB) in pregnancies complicated by maternal anti-Ro/SSA antibodies.

What are the main clinical implications?

  • Polynomial instead of linear reference ranges should be considered to assess fetal AV intervals in pregnancies complicated by maternal anti-Ro/SSA antibodies.

Fetal Diagn Ther (2023) 50 (6): 430–437. https://doi.org/10.1159/000533280
Mini-Summary

  • What does this study add to current knowledge?

    • Fetuses with congenital CMV infection without signs of severe CMV fetopathy present subclinical biventricular myocardial dysfunction showed by significant impairment of the global longitudinal strain obtained by 2D speckle-tracking echocardiography.

  • What are the main clinical implications?

    • Fetal myocardial dysfunction obtained by 2D speckle-tracking echocardiography in fetuses with congenital CMV infection might identify those with congenital infection during pregnancy and who may require cardiovascular surveillance postnatally.

Fetal Therapy

Fetal Diagn Ther (2023) 50 (6): 438–445. https://doi.org/10.1159/000531406
Mini-Summary

  • What does this study add to current knowledge?

    • Risk assessment of fetuses with congenital diaphragmatic hernia (CDH) is mainly based on the observed/expected lung-to-head ratio (O/E LHR). There are only a few articles evaluating the consistency of the O/E LHR for prediction of neonatal death.

    • Our results showed a similar area under the ROC curve with 80% sensitivity and 73.5% specificity for neonatal death using the O/E LHR cut-off value ≤35% either at the referral ultrasound or at the last scan before delivery. Kappa analysis showed an agreement of 0.8 between the two ultrasound scans for identification of fetuses who will present neonatal death.

  • What are the main clinical implications?

    • Our results showed that the O/E LHR is a good predictor of neonatal death in fetuses with left isolated CDH; however, still there is a need of alternative markers to further improve prediction of neonatal mortality in fetuses with CDH.

Fetal Diagn Ther (2023) 50 (6): 446–453. https://doi.org/10.1159/000531791
Mini-Summary

  • What does this study add to current knowledge?

    • Our survey is the first to document the differences in the management of twin reverse arterial perfusion (TRAP) sequence among fetal intervention centers worldwide, incorporating responses from five continents and 29 countries.

  • What are the main clinical implications?

    • This survey discloses a lack of consensus among the international fetal therapy community in the management of TRAP sequence regarding the ultrasound surveillance eligibility for surgery, optimal surgical technique, and the earliest gestational age for an in utero intervention.

Fetal Diagn Ther (2023) 50 (6): 454–463. https://doi.org/10.1159/000533181
Mini-Summary

What does this study add to current knowledge?

  • The MOMS trial has demonstrated that prenatal repair of spina bifida (SB) significantly improves prognosis. Eligibility criteria for prenatal repair defined for the randomized trial are still being adopted by most centers offering prenatal repair. This study shows that several eligibility criteria can be modified or abandoned without maternal and/or fetal disadvantages.

What are the main clinical implications?

  • Several eligibility criteria formerly published by the MOMS trial can be modified or abandoned after careful consideration of medical and ethical aspects without negative impact, thus allowing more fetuses to benefit from prenatal surgery.

Fetal Diagn Ther (2023) 50 (6): 464–471. https://doi.org/10.1159/000533202
Mini-Summary

What does this study add to current knowledge?

  • We describe a case series of monochorionic twin pregnancies complicated with twin-to-twin transfusion syndrome (TTTS) who were successfully treated with placental laser therapy after 26 weeks and compared perinatal outcomes with a control group of cases managed with amniodrainage and/or emergency preterm cesarean delivery (CD). In our study, laser therapy in late TTTS was associated with better perinatal outcomes (higher survival rate and lower frequency of preterm delivery) than traditional management with amniodrainage and/or emergency preterm CD.

What are the main clinical implications?

  • The first line of treatment in monochorionic twin pregnancies complicated with TTTS between 15 and 26 weeks is laser coagulation of placental anastomoses by fetoscopy, but cases presenting after 26 weeks of gestation laser therapy can be challenging and it is hardly recommended in most centers. Therefore, such cases are usually managed with serial amnioreduction and/or emergency preterm CD. Our results support the potential superiority of laser therapy compared to emergency preterm CD in late TTTS between 26 and 31 weeks, and thus, in centers with fetoscopic experience, laser therapy should be considered the first therapeutic option.

Fetal Diagn Ther (2023) 50 (6): 472–479. https://doi.org/10.1159/000533348
Mini-Summary

What does this study add to current knowledge?

  • We describe a case series of singleton fetuses with neck masses and suspected airway obstruction where fetal endoscopic tracheal intubation following fetal laryngoscopy was successfully performed in all cases. All fetuses were born with a secure airway, and maternal harm related to an ex utero intrapartum treatment procedure was avoided. The technical aspects of this technique are described.

What are the main clinical implications?

  • Fetal endoscopic tracheal intubation is a safe procedure, which could become the gold standard for securing the neonatal airway in those with suspected airway obstruction.

Research Article

Fetal Diagn Ther (2023) 50 (6): 480–490. https://doi.org/10.1159/000533203
Mini-Summary

What does this study add to current knowledge?

  • This study proposes a novel pipeline to automatically delineate fetal head and brain structures and obtain automatic measures of each anatomical standard plane acquired during routine fetal ultrasound (US) examination. The results of this study also support further research to develop automated artificial intelligence (AI) methods to improve the visualization, delineation, and classification tasks in maternal-fetal US imaging.

What are the main clinical implications?

  • This study demonstrates that the application of AI could improve clinical practice in fetal US. If the proposed techniques were implemented in software integrated in the US machine, they would help in the visualization of important brain structures in real time during the US examination. This application could also measure automatically other relevant parameters standardizing them, thus avoiding operator bias which depends on their experience and other factors.

Basic Science and Pathophysiology

Fetal Diagn Ther (2023) 50 (6): 491–500. https://doi.org/10.1159/000531750

Acknowledgement to the Reviewers

Fetal Diagn Ther (2023) 50 (6): 501. https://doi.org/10.1159/000534357

Contents

Fetal Diagn Ther (2023) 50 (6): 503–510. https://doi.org/10.1159/000535254
Close Modal

or Create an Account

Close Modal
Close Modal